NCLEX-RN · 6–12% of the exam
Across the life span: prevent, screen, and teach so it sticks.
Health Promotion and Maintenance follows clients from before birth to older adulthood. Its questions test growth and development, prevention and screening, and, above all, whether your teaching actually worked. Here's what it covers and how its questions work.
Many Health Promotion items end with the same question: "Which statement by the client indicates the teaching was effective?" or "...needs further teaching?" To answer them, you need to know the right information and recognize when a client's words show they've misunderstood it.
01 / Scope
What it covers.
NCSBN defines it as "the nurse provides and directs nursing care of the client that incorporates the knowledge of expected growth and development principles, prevention and/or early detection of health problems, and strategies to achieve optimal health." It makes up 6–12% of scored content items on the 2026 NCLEX-RN. The test plan's activity statements include:
- Across the life span: care and education for newborns and toddlers, children and adolescents, adults, and older adults.
- Pregnancy and birth: prenatal care, care of the client in labor, and postpartum care and education.
- Prevention and screening: targeted screenings such as vision, nutrition, and depression; preventive care; and health risks based on family, population, and community.
- Teaching: assessing readiness to learn, learning preferences, and barriers; reducing communication barriers; and community health education.
- Home and self-care: assessing a client's ability to manage care at home, and comprehensive health assessments.
02 / Strategy
Teaching that works: check understanding with teach-back.
AHRQ's Health Literacy Universal Precautions Toolkit describes teach-back: asking clients to state in their own words what they need to know or do. It's a check on how well you explained, not a test of the client. The related show-me method asks the client to demonstrate a skill, such as using an inhaler.
Assess readiness
Is the client ready and able to learn right now? Pain, anxiety, and language barriers come first.
Teach in plain language
Focus on the few things the client must know or do, and use their preferred way of learning.
Teach-back or show-me
"Tell me in your own words..." or "Show me how you'll..." Re-teach anything that's unclear.
03 / Practice
Practice questions.
These are original practice items written by NurseCaseLab, not real NCLEX items.
The nurse has finished teaching a client about a new medication. Which approach best confirms the client understood?
- A. Ask, "Do you have any questions?"
- B. Ask the client to explain, in their own words, how and when they'll take the medication
- C. Give the client a printed handout to read at home
- D. Ask, "Do you understand everything I told you?"
Teach-back, asking the client to explain in their own words, shows whether the teaching worked. Yes-or-no questions (A, D) often get a "yes" even when the client is confused, and a handout (C) supports teaching but doesn't confirm understanding.
The nurse teaches new parents about safe sleep. Which statement by a parent indicates a need for further teaching?
- A. "We'll always put the baby on her back to sleep."
- B. "Her crib will have a firm, flat mattress with just a fitted sheet."
- C. "We'll put a soft pillow and a bumper in the crib so she's comfortable."
- D. "She'll sleep in her own crib in our room."
Safe to Sleep guidance says to keep soft objects, pillows, crib bumpers, and loose bedding out of the baby's sleep area, because they raise the risk of sudden infant death and suffocation. A, B, and D all reflect safe sleep recommendations.
04 / Study plan
How to study Health Promotion and Maintenance.
- Practice "needs further teaching" items. Read each option as something the client said, and ask whether it's safe and correct.
- Learn development by age group: expected milestones and the safety risks typical of each stage.
- Know the major screening and prevention topics covered in your program, by age and risk group.
- Review pregnancy, birth, and postpartum care and newborn teaching, which this area covers explicitly.
Keep studying
Related guides.
Practice under exam conditions
Practice teaching and prevention items with rationales.
NursingProxy's NCLEX Simulation Lab uses unfolding clinical-judgment cases and NGN-style items, with rationales for every question.
Explore the NCLEX Simulation Lab Relationship disclosure: NurseCaseLab and NursingProxy are related learning properties. This external resource is optional and isn't required to use this guide.Sources & further reading
Go to the source.
- NCSBN, 2026 NCLEX-RN Test Plan (PDF)
- AHRQ, Health Literacy Universal Precautions Toolkit, 3rd Edition (teach-back)
- NICHD Safe to Sleep, Frequently Asked Questions
Practice questions are original NurseCaseLab items, not NCLEX items. NCLEX is a registered trademark of NCSBN; NurseCaseLab isn't affiliated with or endorsed by NCSBN. Infant safe sleep guidance comes from NICHD's Safe to Sleep campaign and the American Academy of Pediatrics.